Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 07084 | Date 05/12/2019 |
| Token No | SM/19-20/14723 05/12/2019 | Serial | 051 Last Visit: 05/12/2019 |
| Patient Name | Mr. BIJON KUMAR KUNDU | Contact No | 9681596440 |
| Address | 68A A.P GHOSH ROAD CHATRA SERAMPORE | Age | 36 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 51 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||